It's not necessary to do any additional work to the card, except signing the back -- although you could also print out the backside as well. The back of the card typically contains the name of the artist, contact information (such as an email address), and the title of the artwork. The back can be as simple or as elaborate as you like. Some artists will create a standard template for the back of the card, personalizing each ATC with a title and perhaps the date of creation or the date traded.
The illustrated card is a piece of artwork created entirely on the computer using photographs, photo objects, and graphics software. Originally larger, it's been reduced to ATC size, printed on semi-gloss inkjet photo paper, cut out, then glued to a piece of card stock.
